[Evaluation of 114 abnormal Pap smear follow-up in ambulatory care.]

In France, cervical cancer screening has led to a decrease in mortality, though it could be optimized by improving the management of abnormal cytology. The aim was to evaluate the follow-up of women with abnormal Pap smear prescribed by an ambulatory health professional, compared to the ANAES guidelines of 2002.

Quantitative monocentric and retrospective study of 120 women with abnormal Pap smear performed before October 2014 in the French department of the Loire.

114 abnormal Pap smear follow-ups of women between the ages of 18 and 75 have been analyzed. Cytological abnormalities were spread among 90 ASC-US (79%), 16 LSIL (14%), 6 HSIL (5,3%) and 2 ASC-H (1,7%). Compared to the ANAES guidelines, 52% of follow-ups were incomplete, 24% were comprehensive with too long of a delay, and 24% were guidelines compliant. Women under 29 were more likely to have an incomplete follow-up: OR 0,306 [0,116-0,805].

In our sample, the analysis of the follow-ups of women with abnormal Pap smear has reflected over screening and lack of conformity, eventually allowing the screened lesion to progress towards cancer. A national screening program could help to improve the quality of a follow-up for these women.